Underwater Endoscopic Mucosal Resection of Large Duodenal Adenomas

Abstract Background and aims Endoscopic mucosal resection (EMR) is a well-established method for the removal of neoplastic polyps throughout the GI tract. EMR typically involves insufflation of the lumen using air or CO2 , followed by submucosal lifting of a polyp to minimize the risk of deep tissue...

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Bibliographic Details
Published in:Video journal and encyclopedia of GI endoscopy 2014-12, Vol.2 (3-4), p.84-86
Main Authors: Flynn, Mary M, Wang, Andrew Y
Format: Article
Language:English
Subjects:
Duodenal adenoma
EMR
Endoscopic mucosal resection
Gastroenterology and Hepatology
Surgery
UEMR
Underwater EMR
Video
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Summary:Abstract Background and aims Endoscopic mucosal resection (EMR) is a well-established method for the removal of neoplastic polyps throughout the GI tract. EMR typically involves insufflation of the lumen using air or CO2 , followed by submucosal lifting of a polyp to minimize the risk of deep tissue injury and perforation, followed by hot-snare polypectomy. Underwater endoscopic mucosal resection (UEMR) is a new technique that uses water to enable lesion visualization in a lumen that is not distended by air or CO2 , followed by piecemeal hot-snare resection of large mucosally-based neoplasms. UEMR does not require submucosal injection to create a fluid cushion. Very few published examples of UMER in the duodenum exist. This video case series describes the use of UEMR for the resection of several large duodenal adenomas. Procedure Underwater endoscopic mucosal resection was utilized for the removal of several large duodenal adenomas. Results Three duodenal lesions ranging from 1.8 cm to 5 cm were successfully resected by UEMR. The mean time for resection was 18 min. There were no adverse events. Conclusions UEMR is an efficacious technique for the resection of large mucosally-based neoplasms of the duodenum.
ISSN:2212-0971
2212-0971
DOI:10.1016/j.vjgien.2015.02.002